Sunday, November 12, 2017

Listen up! What not to say to a nurse or nursing student with a disability

Painting by Thomas Saliot

A group of nurses and nursing students with disabilities was asked to share comments made to them. Responses included the following:

"Maybe this is God's way of saying you shouldn't be a nurse."

"You will not be able to work as a nurse."

"There are no accommodations in nursing school."

"Let me do it for you." 

"How are you going to be a nurse when you look like a patient?"

"What's wrong with your neck?"

"Why are your hands always shaking?"

"You can't go in there blind."

"How can you be a nurse if you are hard of hearing?"

"Maybe you should go on disability".

"Turn up your hearing aid."

"People with ________can't make good nurses."

"You don't look like you have a disability."

"Nobody wants a nurse with a bad back."

In health assessment lab, "You can go outside in the hall and read."

"You should think about another career choice."

"You don't look sick."

"Do you know what patients think when you limp into their room with a service dog?"

"Who is going to hire you?"

"I knew something was wrong with you from the start."

"What's your problem? Can't you hear?"

"If you use a wheelchair and have a service dog, how will patients know you are the nurse?"

"You can't work in _____area because of your speech impediment."

"You can't be a nurse. You struggle to walk." 

"Why do you want to work when you could sit home on disability?"

"What's your problem, can't you hear?"

"You don't have what it takes to make it."

"Patients won't want you to care for them."

"What kind of nurse will you be with one leg?"

"You can't do that."


Love to read your thoughts!


Sunday, October 22, 2017

Welcome to Florida: A parable for nurses who become disabled

      At some point in time, most parents of children with disabilities come across the “Welcome to Holland” message written by Emily Perl Kingsley in 1987. The message originally appeared in the Los Angeles Times, in Abigail Van Buren’s “Dear Abbey” column. For those who aren’t familiar with the story, it’s about someone who plans a vacation to Italy but ends up in Holland instead. This story has guided my life as a parent of a child who is disabled and my work as a nurse and nursing educator. Below, I have adapted this message for nurses who become disabled.

            I am often asked to describe the experiences of nurses who become disabled — to try to help people who have not shared that unique experience understand it and imagine how it would feel. It’s like this…

            It’s like planning a fabulous trip to New York City after graduating from nursing school. You plan to work at a prestigious medical or research center there. You buy a new stethoscope, lab coat, scrubs and medication handbook. You plan to work as a staff nurse and eventually get promoted to unit manager of a busy intensive care unit or emergency department. On your days off, you are eager to visit the Statue of Liberty, Ellis Island and the Metropolitan Museum of Art. You can’t wait to see the bright lights, Time Square and Broadway. It’s all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags, and off you go. Several hours later, the plane lands. The flight attendant comes in and says, “Welcome to Florida.”

            “Florida?” you exclaim. “What do you mean Florida? I signed up for New York! I’m supposed to be in New York. All my life I’ve dreamed of going to New York. I’m not old enough to move to Florida!”

            But there’s been a change in the flight plan. The plane has landed in Florida, and there you must stay. The reason is that you have a disability.

The important thing is that they haven’t taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It’s just a different place.

            So you must go out and buy new guide books. And you need to learn a whole new language — the Americans with Disabilities Act, vocational rehabilitation, reasonable accommodations — and perhaps go back to school for an advanced degree. You may need to buy some new equipment and learn new ways of performing your nursing skills. But a bonus will be that you will meet a whole new group of people whom you would never have met.

            Florida is just a different place. It’s slower-paced and less flashy than New York. But after you’ve been there for a while and you catch your breath, you look around and begin to notice that Florida has beaches, warm weather, magnificent sunsets and palm trees. Florida has the Salvador Dali and Morikami museums. And it has patients who still need your care — in hospitals, nursing homes, health departments, schools, community centers, camps, case management, infection control, administration, teaching and
research positions.

            But everyone you know is busy coming and going from New York City. And they’re all bragging about what a wonderful time they are having as nurses in New York. For the rest of your life, you will say, “Yes, that’s where I was supposed to go. That’s what I had planned.”

The pain of that will never, ever, ever, ever go away, because the loss of that dream is very significant.

            But if you spend your life mourning the fact that you didn’t get to New York City, you may never be free to enjoy the special, lovely things about being a nurse in Florida.

This is an excerpt from the book "Leave No Nurse Behind: Nurses working with disAbilites". 

Please share your thoughts below.

With thanks,

Monday, October 16, 2017

Advice for healthcare providers from a nurse with autism

Anita Lesko, BSN, RN, MS, CRNA

As a mother of a daughter diagnosed with autism and related disabilities, I am so pleased to announce the publication of Anita Lesko's much needed book. It should be required reading for nursing, nurse practitioner, medical and allied healthcare students. It would also make a wonderful gift for parents to give to their child's healthcare provider.

The book provides quality advice from a nurse with autism! 

"The book is geared for use in healthcare curriculum courses, as well as a guidebook for all healthcare and allied healthcare providers. It's important for healthcare professionals to realize that communication starts at the Admissions Desk and follows through to the patient's discharge, Whether the patient is simply going for a routine doctor's appointment, or getting admitted for major surgery, the autism patient needs specialize care for optimal results."

"This book is a comprehensive guide in understanding autism, formulating effective communication strategies, and developing best care practices. It covers sensory issues, pain tolerance, body awareness, communication challenges, legal and ethical issues, HIPPA compliance and the Americans with Disabilities Act." 

Congratulations Anita! 


Thursday, October 12, 2017

Breath of a nurse with a tracheostomy

Michelle DiGiacomo, LPN

Born and raised in New Orleans, Louisiana, I am 44 years old and divorced with one daughter.  Neither of my parents attended college. My mother was born in the USA but my father is a Cuban refugee who sought asylum here in 1961. I attribute my determination to them.

I attended a local university right after high school, unsure of what I wanted to study. In my senior year, I decided to take a year off to get married. I later learned that I had obstructive sleep apnea.  Because I only had a health insurance policy through school, I went to Charity hospital. I was told that the solution to this problem was a trach to allow me an alternate airway to avoid my obstruction. I was not told about a CPAP machine or offered other less severe procedures.

 After the trach, I was unable to speak for 6 months. I was depressed and certain that this was it for me. No career. No normal life. Awarded social security disability.  When our family moved to Memphis, I found a new ENT to oversee my care. This doctor explored the nature of my obstruction and determined that my over-sized tonsils formed a barrier with my uvula.  After surgery, I was able to reverse the trach. But, just a few months later, I started having difficulty breathing again.  This time, the culprit was scar tissue at the site of the original trach. It was suggested that the first procedure was done incorrectly. Where the trach should have been excised, it was folding back and the outer portion of my neck, skin that I needed later, was removed. This made it bulky and pulled in irregular ways. I endured 5 more procedures in an attempt to correct this stenosis before it was decided that it was a permanent situation.

I will always have to have scar tissue surgically removed every few years.  When I have 50-60% of my airway open, I can comfortably cap my trach or wear a speaking valve.  When scar tissue grows, I have to leave it open to breathe below the problem area.  Other than that, I don't have any respiratory issues.

I could not fathom a job that I could do. Depressed, I thought life was over. I stayed home to avoid public stares and questions. It was not living at all. Then one day it all changed. I was out, forced by my family, and a stranger was staring at me. After the meal, she approached to explain and apologize. She said that she had a baby who has a trach and seeing me out with my family, living a normal life as she put it, gave her hope for own child's future.  In the next few days, I went out more and had similar experiences. That's when I knew that my trach could be useful. My life could be used as a living testimony and example for others.

So, with a tracheostomy, a toddler and no hope of working, I decided that I wanted to complete my Bachelor's degree in nursing. After applying and being rejected from every nursing program in Louisiana, Hurricane Katrina forced me to relocate. The good news is that the move provided new nursing programs to consider.  I applied and was rejected by RN programs in Tennessee, Mississippi, and Arkansas. I was very sure that my trach was the reason for my rejections. I had to find another way!

 I read that licensed practical nurses (LPNs) could get nursing degrees online. I didn't even know what an LPN was but I decided that I had to become one so that I could use that avenue to get to my ultimate goal. I applied and was rejected by a few LPN programs until I found one that accepted me. The Director of Nursing explained all of the reasons that she did not want me to attend and all the reasons that she legally could not stop me.  She  hoped I would forfeit my place for someone who had a chance at success.

I claimed my rightful place!

So began my mission. I met more than a few critics and doubters and hit one brick wall after another but I refused to give up!  I started to think, even if I cannot actually work in the field, I still wanted to know if I could succeed. If I had the stuff to become a nurse. Once I finally got into a program, there was no stopping me. It was there that I got my first support. Not from the instructors, or administration, not even from my husband, but from the patients I met at clinical sites.  Before them, I was pretty sure I was wasting my time. In the hospitals, I was so well received by staff and patients. I was encouraged by everyone at every turn.  I freely answered questions, taught my fellow students from my experience and began to accept this as part of me. It was no longer a problem, just a difference.

I graduated with a 3.86...third in my class!

I have never had any difficulty getting a job or been mistreated by employers.  I have had issues with coworkers. The main issue on the job has been questions about infection control. Once the facility and legal department are satisfied that I am not at any additional risk, I am hired and treated as everyone else. I have not needed any accommodation except when I need time off for procedures.

My first job was at a skilled nursing facility in Memphis. Then, I was hired at a large hospital in New Orleans in the oncology department.  An RN and LPN team provided total care for a pod of up to 8 patients, many receiving chemotherapy, radiation or a bone marrow transplant. I also worked PRN at a home infusion company as a clinical liaison where I primarily did patient teaching. Later, I was offered a full time position with the  home infusion company monitoring transplant patients on inotrope therapy. After that, I worked in nursing homes. I am currently working in a hospital setting in  long term acute care.  Its med/surg with a fairly high acuity. 

Looking back, I was afraid that life would never be the same after my trach. I was right but not in the ways that I first thought.  I struggled with self-image. I was so young and overwhelmed by the medical equipment.  I had to breathe humidified air several times a day, clean my inner cannula, or use disposable ones. To keep the skin intact around the stoma, I had to fight moisture, suction myself and change the actual trach tube every few months. It was so much to learn and so many ways I had to adapt my life around my special needs.

I am hardly qualified to dole out words of wisdom as I am still trying to figure it out myself. I can say that taking the power back was key for me.  If I allowed my trach to steal my future, then it truly would be a disabling condition. I had to carry on as I would have without it. I lost a lot of time being angry about what amounts to a botched surgery that I didn't need in the first place. Once I decided that I would pursue my career and socialize again, this issue could no longer hurt me. I am living my life and enjoying the same ups and downs as everyone else. I also learned that before I could put actions behind my decisions I had to accept my difference. Once it was no longer a problem for me, it would no longer be a problem for anyone else.

My trach is a part of me, like being brunette, short in stature or female, but it alone does not define me.  I am the sum of all of my parts. So you will never hear me trying to deny my trach, hide it or eliminate it from the equation.  Sometimes, people with disabilities, in their fight for equality, want others to ignore their issues in the hope of being treated like everyone else. But we are not like everyone else. One might even argue, we are in some ways better, stronger, more determined, resilient and empathetic. I will use my trach and any tool in my arsenal—everything I am and every breath I take--- to be the best nurse that I can be.

Michelle can be reached at:

Saturday, October 7, 2017

From nurse to patient to disabled nurse

Danielle M. Fullen MSN/Ed, BSN, RN

       All my life I wanted to work in healthcare.  I graduated high school in 1996 and went to a university majoring in pre-med.  In October, my whole world turned upside down; my mom was diagnosed with Acute Myeloid Leukemia (AML).  It was extremely hard for me to concentrate on school.  I started failing and eventually quit. 
       My mom is the reason I became a nurse.  The nurses took such good care of her. They sat and comforted her, talked with her without rushing her, listened and cried with her. I thank God everyday she survived.
I started nursing school in 1999 at St. Francis Medical Center School of Nursing (no longer exists). It was tough, but I loved it.  I graduated in June 2002.
      My first nursing position was on an adult cardiac step-down floor. Even though I loved working there, I had a nagging feeling that my calling was —working in pediatrics.  In 2003, I accepted a position in the pediatric intensive care unit.  I immediately knew I was meant to be there. 
         Over time, I dreamed of becoming a pediatric nurse practitioner or a flight nurse.  My dreams were crushed in May, 2004.  I started having lower back pain.  I thought I was working too much and it would go away.  It didn’t… it just got worse.  An MRI showed that I had both Degenerative Disc Disease (DDD) and a Herniated Disc (HD) between L4 and L5.  An x-ray showed I had a fracture at L5. 

I refused to give up!

      Physicians said, “You are too young to have back surgery” and “I don’t want to keep giving you narcs”.  I did not want surgery and I did not want narcotics.  I wanted to be better and go back to my life. Physical therapy helped, but only when I was there.  After PT, the pain returned with a vengeance.  I also had 3 Lumbar Epidural Steroid Injections (LESI), which did not help.  On September 7, 2005, I had a spinal fusion from L4 to S1.  My recovery went as planned. I was in PT and the medication and therapy were helping.  I thought my plight was finally going to be over.  I was wrong, very wrong. 

I refused to give up!

         Sometime in 2006, I started having severe, sharp pains in my lower back.  Suddenly, I could barely walk.  There were times I could not get out of bed, and when I tried, I screamed.  I would be awake most of the night crying.  My meds weren’t working anymore. 
         I was back to work in the PICU.  I had such a hard time walking that I had parents, whose children were dying, asking me if I was okay! 
         I went back to my surgeon and had x-rays, CT, MRI, and he could not figure out what was wrong. I ended up losing my job and my remaining dignity.  For a second opinion, I found a reputable orthopedic surgeon. He could tell, just by the x-ray, that all the metal in my lower back was loose.  So, I had my second back surgery, a re-fusion of L4 to S1 with a left iliac crest bone graft.  My recovery process was rough and I never had complete pain relief. 
I refused to give up!

         I tried to work as a floor nurse to no avail.  I ended up having to take a light duty position as a case manager.  I loved it!  But, three months later, I was told the position was temporary and I was forced to resign. Then, I worked at a pediatrician’s office and then told I needed surgery again. 
         I had my third back surgery—a re-fusion at L4 to S1, a fusion at L3 to L4, a laminectomy at L3 and 2 partial laminectomies at L2 and L4.  Since then, my pain has been horrible and excruciating.  My surgeon said I needed to see a pain doctor.  He also told me something I will never forget:

“Danielle, you do know that your nursing career is over now.”  I remain determined to prove him wrong!

         Depression consumed me. Thankfully, I found a wonderful pain management group. They listened, helped, and treated me like a human being.
        In 2009, I applied for Social Security Disability and was denied. My pain doctors gave me medication, spinal injections and a rhizotomy.  The pain remained unbearable.  They decided I should see another surgeon to see if I needed another surgery or if I could be a candidate for a spinal cord stimulator (SCS). 
         In 2011, I saw my third surgeon, for my forth major spinal surgery.  This surgeon tried his best to control my pain. On March 7, 2011, he performed a spinal re-fusion L3-L5 and Dynamic Stabilization between L2-L3.  My recovery was rough. No PT as the pain might increase and interfere with my recovery.   

I refused to give up!

         In 2012, I hired an attorney and applied for social security disability once again. This time I got it! 
         Overall, I had received over 30 epidural steroid injections (ESIs).  Not one ESI ever worked longer than 2 ½ weeks.  The pain doctors wanted to continue giving me the ESIs but I found that they are not FDA approved due to the potential for paralysis.  So, I moved on.
         I found a new team willing to help alleviate my pain. With their help and guidance, I decided to have a spinal cord stimulator (SCS) placed.
         On August 7, 2014, I had the SCS trial and it worked!  It helped decrease my pain by at least 55%.  Since the trial worked, I had another surgery – and the SCS was permanently placed.
         The permanent SCS started out working well; and decreased my pain by about 55%. I finally thought I could go back to work. But once again, I was disappointed.
         For three months, the SCS was effective. Then the pain increased despite the fine tuning. I had this foreign object in my spine doing nothing. On July 6, 2015, I had my sixth spinal surgery – I had the SCS removed and ended up with thoracic pain due to the procedure.
         In spite of the pain, I went to Chamberlain College of Nursing online and graduated with my BSN in 2011.  I then graduated with my MSN in 2013 and later obtained a post-graduate specialization in nursing education. 

I refused to give up!
My nursing career is NOT over!

         Currently, my pain doctors and I are working on a medication combination. The excruciating pain is in my lumbar spine, shoots up to my thoracic spine, and into my left hip and thigh. I have been diagnosed chronic lower back pain, degenerative disc disease, lumbar radiculopathy, lower extremity radiculopathy, spondylolisthesis, spinal fracture (L5), spinal stenosis, lumbar pseudo arthritis, herniated disc (L4-L5), lumbar discogenic syndrome, post laminectomy syndrome, spinal hemangioma, and left hip bursitis.

Through all this excruciating pain, I remain positivePositive that one day, I will have some relief and get back to work in nursing, as a nursing instructor.

Danielle Fullen can be reached at:


Thursday, September 7, 2017

Nursing in the storm

Nursing in the Storm: Voices from Hurricane Katrina by Denise Danna, DNS, RN and Sandra Corday, MA is a compilation of stories from nurses who worked through the storm.
Reviews of the book on include the following comments:

""The accounts are vivid, colorful, descriptive, intense, and often horrific and give cross-sectional views of life in the trenches during this disaster?This book is a rich primary source for both historians and disaster preparedness planners. It's not only a tribute to the courage of the nurses, but should also serve as a guide for policy planners hoping to avoid less than optimal responses to future crises.""--AJN

""[T]he book...fascinates simply for its raw documentation of the dreadful events and conditions endured by nurses, doctors, and ancillary staff as they struggled to care for critically ill patients without electricity, running water, air conditioning systems, and other resources. Five years after the levees broke, the horror and chaos of Katrina is still fresh in these accounts. Through the stories, readers are transported into the hospitals as nurses heroically work together to evacuate babies from NICUs and vented patients from ICU, try to calm patients, family members, and coworkers, and make do with the equipment and supplies they?ve got.""--National Nurse

""Don't ever think that this can't happen to you. You are going to read this and it's going to sound like we created this scenario, but this is a real scenario that happened."" --Pam, Memorial Medical Center

"""Everything that was battery operated eventually died. There were no monitors...we tried to take care of people in the most humane way possible.""" --Lois, Lindy Boggs Medical Center
"Nursing in the Storm: Voices from Hurricane Katrina" takes you inside six New Orleans hospitals-cut off from help for days by flooding-where nurses cared for patients around the clock. In this book, nurses from Hurricane Katrina share what they did, how they coped, what they lost, and what they are doing now in a city and health care infrastructure still rebuilding, still in jeopardy.
In their own words, the nurses tell what happened in each hospital just before, during, and after the storm. Danna and Cordray provide an intimate portrait of the experience of Katrina, which they and their colleagues endured.

Just a few of the heroic nurses you'll find inside:
Rae Ann and twenty others, including her husband and children, who wait on a hospital roof for help to come Lisa, in the midst of caring for patients, who has not heard from her husband in 5 days Roslyn, who has 800 people in her hospital when the power generators shut down Linda, who uses bed sheets to write out help messages on a hospital roof, hoping someone will see them
The book also discusses how to plan and prepare for future disasters, with a closing chapter documenting the ""lessons learned"" from Katrina, including day-to-day health care delivery in a city of crisis. This groundbreaking work serves as a testament to nurses' professionalism, perseverance, and unwavering dedication. " 

Love to read your thoughts about the book.

Stay safe!


Thursday, August 24, 2017

Transgender nurses and nursing students

Mohammed A Memon, MD, Assistant Professor of Psychiatry, Virginia Commonwealth University School of Medicine reported for

"According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5),  for a person to be diagnosed with gender dysphoria, there must be a marked difference between the individual’s expressed/experienced gender and his or her assigned (natal) gender, and it must continue for at least 6 months. In children, the desire to be of the other gender must be present and verbalized. The condition must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning."

"Not all transgender people experience dysphoria, and some controversy exists among the medical community regarding the necessity of the psychiatric diagnosis of gender dysphoria. Many transgender advocates believe that inclusion of this diagnosis increases awareness and helps advocate for health insurance that covers the medically necessary treatment recommended for transgender people."

The Americans with Disabilities Act (1990) explicitly excludes claims based on gender identity. However, a federal court for the first time has ruled transgender people can sue under the Americans with Disabilities Act.

U.S. District Judge Joseph Leeson, determined that a case filed by transgender plaintiff Kate Lynn Blatt filed against Cabela’s Retail, Inc., can proceed because she meets the conditions of the 1990 law. Gender dysphoria, a type of anxiety, was the basis for her claim under ADA.

“[I]t is fairly possible to interpret the term gender identity disorders narrowly to refer to simply the condition of identifying with a different gender, not to exclude from ADA coverage disabling conditions that persons who identify with a different gender may have — such as Blatt’s gender dysphoria, which substantially limits her major life activities of interacting with others, reproducing, and social and occupational functioning,” Leeson stated according to

Times have changed since passage of the ADA in 1990 and complicated questions surrounding disability issues related to employment of transgender nurses, as well as the education of transgender nursing students, are being asked. Links to related stories and more information are included below. 

Please feel free to share a comment.

With thanks!


Saturday, August 19, 2017

2017 Scholarships awarded to nursing students with disabilities

         Nursing students with a wide range of disabilities are increasing in number every year. Disabilities may include hearing loss, low vision, learning disabilities, limb differences, paralysis, mental illness, autism and chronic conditions such as multiple sclerosis, lupus and movement disorders.

Financing an education can be a challenge for some students with disabilities. In addition to routine expenses (tuition, room and board, books, uniforms, transportation), some students may need to purchase an amplified or electronic stethoscope, computer software programs, or audio books—as well as medications, hearing aids, therapies, prostheses, special equipment or custom alterations to uniforms and lab coats. Working a part-time job may not be possible.

Scholarships are available from, a nonprofit resource network for nursing students and nurses with disabilities. The organization provides links to disability-related organizations, technology, equipment, financial aid, employment opportunities, mentors, blogs, continuing education, a speaker’s bureau, legal resources, social media groups, research and related articles.

The organization has been awarding scholarships to nursing students with disabilities since 2003. The awards are based on academic performance, letters of recommendation, financial need and an essay which answers the questions: “How do you plan to contribute to the nursing profession? How will your disability influence your practice as a nurse”? The awards this year were $500.00. is honored to announce the winners for 2017!!!
Allison Winchell  from Newton, Iowa will be attending the Newton Campus of Des Moines Area Community College in Iowa.

Allison wrote, "When I was in the hospital that long scary month I remember how amazing the nurses in that hospital were. Their eyes just glowed with kindness and the desire to be a blessing to people in need. I want to become that kind of nurse."

Jonathan Louwsma from Imlay City, MI will be attending Calvin College in Grand Rapids, MI.

Jonathan stated, "Sometimes I feel, my "disability" has given me my "ability" to focus on my strengths and to perfect these areas. I know that I can be a positive example and inspiration for my patients.."

Mikayla Magna from Hawthorne, New Jersey will be attending Ramapo College of New Jersey.

Mikayla wrote: "Learning different from everyone else always helps me keep a different outlook to all areas of life. I feel my journey will help me impact the life of my patients and will carry through in my care given to them."

Rachael Mahan from Roanoke, Texas will be attending Texas Woman's University.

Rachael shared, "Thanks to the obstacles and disabilities that I have overcome in my short life, I have the drive necessary to do the best for my patients and their families."

Jamie Anderson from Cliffside Park, New Jersey is attending Ramapo College  of Nursing in New Jersey. 

Jamie stated,  "I would like to become an APN specializing in emergent care and trauma. I would like to join Doctors without Borders or the Peace Corps and help those in real need!"

Congratulations and best wishes to all!!!

The scholarship awards are funded through donations, grants and proceeds from book sales of “The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities”, “Leave No Nurse Behind: Nurses working with disabilities” and “Nursing students with disabilities change the course”. To make a donation, please visit

The scholarship application can be downloaded at

Appreciate your support!


Sunday, August 13, 2017

Nurses who self harm

In 2016, Teris Cheung and Paul Yipp published the results of a study, "Self-harm in nurses: prevalence and correlates." The aim of the study was to examine the weighed prevalence of self-harm and its correlates among Hong Kong nurses. The background of the study included the following:

"Recent epidemiological data suggest that the weighted prevalence of past-year suicidality among Hong Kong nurses was found to be 14 9%. Deliberate self-harm was a significant correlate of suicidality. Nonetheless, there are few population-based studies exploring the prevalence of self-harm and its correlates among medical occupational groups in Asia."

"The study used a cross-sectional survey design. Data were collected in Hong Kong over a four-week period from October–November 2013. Statistical methods, including binary and multivariate logistic regression models, were used to examine the weighted prevalence of selfharm and its associated factors in nurses."

"A total of 850 nurses participated in the study.  Seventy-nine participants (9 3%) reported self-harm in the past year. Nurses aged between 25-44 were at especially high risk of self-harm. Female nurses reported self-harm more than male nurses. The most common forms of self-harm were self-cutting, striking oneself and poisoning oneself. Clinical experience, chronic illness, relationship crises with family members, a family history of self-harm, smoking, symptoms of stress and psychiatric disorder were significantly associated with nurses’ self-harm. The

positive correlation between psychiatric disorder and self-harm was confirmed." 

The researchers concluded that "there is a need for a raft of self-harm prevention strategies, including a continuous monitoring system in the healthcare setting detecting and managing

the risks of self-harm in nurses as part of the ordinary provision for their well-being."

The complete results of the study can be read by clicking on the link below.

Cheung T.Yip P.S.F. (2016) Self-harm in nurses: prevalence and correlates. Journal of Advanced Nursing 72(9), 21242137. doi: 10.1111/jan.12987

Please feel free to leave a comment.

With thanks,


Tuesday, August 1, 2017

Medical and recreational cannibus use by nurses and nursing students with disabilities

Questions have been asked regarding the implications of medical marijuana use by nurses or nursing students with disabilities. An article published by, "Marijuana and Your Job: What You Need to Know" by Carolyn Buppert, MSN, JD, a healthcare attorney, is important reading. 

Ms. Bupert responded to this question, "Can I be fired for using marijuana at home or for using recreational marijuana on my day off, when recreational use is legal in my state?" 

"The take-home message for nurses (and all healthcare professionals) is: If you want to protect your career, don't use marijuana recreationally, even if it is legal in your state and even if you use on your own time and off premises. It is still illegal under federal law. If you decide to take a legal risk and partake in marijuana, don't do so for at least a month before you will be working. Employers don't all conduct random drug tests, but some do, and sometimes nurses are included in widespread drug testing, even if the individual nurse has not been accused of being impaired. It is so much easier to prevent this legal problem than to deal with it after being fired."
"Furthermore, we don't know how Boards of Nursing stand on the 
issue. Nurses have reported that they have lost their licenses 
and/or been referred to impaired nurse programs for testing 
positive for marijuana. We don't know how every Board of Nursing 
would act on any given day, but at minimum, a firing would lead to 
a report to the Board of Nursing, and then the burden is on the 
nurse to prove he or she was not impaired at work. That, too, is 
more easily prevented than dealt with after the nurse is reported."

Nurses and nursing students should continue to keep a careful eye on the current legal implications surrounding use of medical or recreational cannibus. 

The complete article published on Medscape and other information can be found below.


Sunday, July 16, 2017

"The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities" review from the UK

"The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities" was reviewed on in the UK.

This book contains individual chapters written by nurses with a wide range of disabilities: their stories are testimony to the exceptional courage, flexibility and resilience they demonstrate whilst practising their chosen vocation. They bring these qualities to the workplace, as well as serving as role models and advocates to other students, patients, helpers and educators. For example, one nurse with diabetes brings a special ‘willingness to listen to patients talk about being sick, being hospitalised, frightened and powerless, and vulnerable.’

You will also find practical information on how to navigate ‘the system’ in order for reasonable adjustments be made and support accessed from a wide number of sources. A British readership would not be able to benefit from this information, as it is naturally culturally, linguistically and legally biased towards an American audience. For this reason only I would afford the book 4 stars, and would warmly welcome a similar publication geared in tone and content to readers in the United Kingdom.

In sum, this innovative and unique book is well written, clearly structured, extensively researched and moving. As such, it should be set reading in medical education.’

What do you think? Please share your thoughts....

Friday, July 7, 2017

Not a Sound: A thriller for nurses with disabilities!

New York Times bestselling author Heather Gudenkauf 's new book is fiction. But insights the author gained from being raised by a nurse and personally living with a profound unilateral hearing loss makes so much of the book ring true! 

"When a tragic accident leaves nurse Amelia Winn deaf, she spirals into a depression that ultimately causes her to lose everything that matters—her job, her husband, David, and her stepdaughter, Nora. Now, two years later and with the help of her hearing dog, Stitch, she is finally getting back on her feet. But when she discovers the body of a fellow nurse in the dense bush by the river, deep in the woods near her cabin, she is plunged into a disturbing mystery that could shatter the carefully reconstructed pieces of her life all over again."

The thriller is a great read...hard to put down!

I only wish the author had included more nursing career opportunities for Amelia Winn following the incident that lead to her deafness.

Love to hear what you think of the book.

Please leave a comment below.



Wednesday, June 7, 2017

Silent No More! Delnor nurse beaten and raped!

Attorneys representing two nurses and a nurse’s husband called a press conference to counter official statements that nurses taken hostage at Northwestern Medicine Delnor Hospital were not injured in a May 13 incident in which a jail inmate was shot dead by a SWAT team.

The horrific events at Delnor Hospital cannot be forgotten or pushed under the rug. Nurses need to stand together for much needed change.

With thanks to Janie Harvey Garner, RN (Show Me Your Stethoscope) for her passionate "shift report" on this situation.

And to Zubin Damania, MD (ZDoggMD) for sharing this story. He spoke with the nurse who was beaten and raped. Please share his call to action.

We can all do something! Share the story on social media, send a card or note of support, talk about it with your colleagues, family and friends. Silent No More!

Delnor Nurse
P.O. Box 394
Sycamore, Il 60178 
With thanks!!


Saturday, June 3, 2017

The nurse with dementia: Where do we go from here?

Gail Weatherill, RN, BSN

The British Royal College of Nursing (RCN) recently shocked many by passing a resolution that nurses with dementia should be supported to continue practicing as long as possible. Their reasoning was that most fears of these nurses constituted discrimination based on old prejudices and misconceptions.

The public, including many nurses, assumes that individuals are “suddenly struck incompetent” at the time of diagnosis. In fact, cognitive changes usually occur in minor, subtle ways over a matter of years.

There are many individuals with dementia who continue to lead productive lives for years after their diagnosis. Like those with other disabilities, they find ways to adapt their routines to compensate for a faulty memory. They write books, give talks to raise awareness, and weigh in on policy matters affecting those with dementia.

To better understand the unique challenges a nurse with dementia faces, I spoke with Frani Pilgrim, RN. Frani is an American nurse with Early Onset Alzheimer’s Disease (EOAD). Early Onset Alzheimer’s Disease affects those under 65 years old. It is increasingly more common among people in their thirties, forties, and fifties.

In January of 2016, Frani Pilgrim was busy in the Allergy and Asthma practice where she served as a nurse specialist. At 56 years old, she relished the “dream job” she had excelled in for the past ten years. But when she could not master the new electronic medical record system, both she and her coworkers began to wonder why.

Frani was caught off guard one day when her beloved physician mentor said to her, “Frani, you’re not yourself. Something’s wrong. We need to find out what.” With four generations of EOAD behind her, Frani suspected her fate even before neuropsychiatric testing confirmed it. Having watched her grandfather, father and a brother live with EOAD, Frani fully understood the weight of her diagnosis.

A year and a half later, Frani’s life has changed dramatically. Because of concerns about liability, she chose to resign her position at the time of her diagnosis, saying, “How would a family feel if I made a mistake, and they found out I have Alzheimer’s?” Exiting her nursing practice was “the hardest thing I have ever had to do. Nursing is different from other careers. It’s not a job. It’s who we are.”

Frani experienced a period of deep despair, “I spent one month in bed, crying.” “Nursing was everything to me, but I felt I had no choice but to give it up.” Over time, Frani moved through her acute grief and began to see a silver lining to her circumstances. Away from the stress and physical demands of nursing, her symptoms improved. With time on her hands, she focused on home and family relationships which deepened in a positive way.

“I’m a survivor”, Frani explains. “I’ve survived breast cancer, cervical cancer, and a near-death experience with asthma. But Alzheimer’s is different. You know there’s no going back.” Frani underwent driver’s testing at the Division of Motor Vehicles which she passed with flying colors. She plans to return once a year for testing, saying, “I know it’s not always clear to a person what their own degree of impairment is. I don’t want to take any chances.”

Today, Frani keeps physically active and is quick to share her experience with others. She recently enrolled in a clinical trial which gives her great comfort. “Even if it doesn’t help me, maybe it will help my son. I look at him and his physical resemblance to his grandfather, and I pray a lot.”

When I asked Frani what she most wanted her fellow nurses to know about her illness, she said without hesitation, “That people don’t become idiots when they are diagnosed.” She recounts the pain of family prejudice, including those who would no longer allow her to babysit her grandchildren once they learned of her diagnosis.

Alzheimer’s Disease and related dementias now affect over 5 million people in the US alone. Great Britain, Australia, Canada and Asia all face the far-reaching socioeconomic effects of dementia in an aging population as well as those with EOAD. As the average age of clinicians increases, the question of what to require of nurses with dementia is only due to become more common. Great Britain has chosen inclusion of nurses with dementia.

Additional questions arise such as, is a nurse with mild dementia a greater risk to patients than a stressed, exhausted bedside nurse? What about the nurse with diabetes whose cognition can drop with a low blood sugar? Or, a nurse with Post Traumatic Stress Disorder faced with a trigger? Are there teaching and some management positions that nurses with EOAD might fill?

A knee jerk reaction of, “That’s crazy! Patients must be protected,” may have to be weighed with the reality of mild dementia with minor lapses and an aging nursing workforce. One thing is for certain; this question will only arise more frequently in the years to come. It is already upon us and in need of answers.

Thank you Gail for shedding light on this important topic!

Please feel free to weigh in on Gail's point of view. 

With thanks,


About the author:
A practicing nurse since 1980, Gail Weatherill specializes in the care of people living with dementia. A graduate of the University of Virginia, she has obtained board certifications in Alzheimer’s education and care. Her years in critical care, home health and long-term care in the US and in Saudi Arabia influence her far-reaching perspective on nursing care. Gail resides in Charlottesville, VA where she can easily travel to her state capitol and the United States Capitol for advocacy work for dementia care and safe staffing ratios. You can find her at the site named for her professional alter ego, The Dementia Nurse ™.